两种术前检查方式对子宫内膜恶性肿瘤患者腹腔细胞学检出率及随访生存率的影响

Influence of two kinds of preoperative examinations methods on detection rate of peritoneal cytology and the survival rate of patients with endometrial carcinoma

摘要:

目的 探讨术前宫腔诊刮术与宫腔镜检查对子宫内膜恶性肿瘤患者腹腔细胞学检出率及随访生 存率的影响。方法 研究对象选取该院2011 年3 月-2013 年12 月收治的子宫内膜恶性肿瘤患者120 例，根 据术前检查方式差异分为诊刮组（64 例）和宫腔镜组（56 例），分别在术前采用宫腔诊刮术与宫腔镜检查； 比较两组患者标本合格率、病理诊断一致率、腹水细胞学检出率、随访3 年总生存率和无进展生存率等。 结果 两组患者标本合格率和病理诊断一致率比较差异无统计学意义（P >0.05）；宫腔镜组患者腹水细胞学 检出率明显高于诊刮组（P <0.05）；同时两组患者随访3 年总生存率和无进展生存率比较差异无统计学意义 （P >0.05）。结论 宫腔诊刮术与宫腔镜检查用于子宫内膜恶性肿瘤诊断价值相当，但宫腔镜检查可能增加腹 腔转移风险，但对远期生存并无影响，有待更大规模随机对照证实。

Abstract:

Objective To investigate the influence of curettage of uterine cavity and hysteroscopy detection before operation on detection rate of abdominal cavity and the survival rate of patients with endometrial carcinoma. Methods 120 patients with endometrial carcinoma were chosen in the period from March 2011 to December 2013 were divided into 2 groups including curettage of uterine cavity group (64 patients) with curettage of uterine cavity and hysteroscopy group (56 patients) with hysteroscopy detection according to preoperative examinations methods; and the eligible rate of specimens, the concordance rate of pathological diagnosis, the detection rate of peritoneal cytology, the overall survival rate and progression free survival rate in 3 years with followup of both groups were compared. Results There was no significant difference in the eligible rate of specimens and the concordance rate of pathological diagnosis between the two groups (P > 0.05). The detection rate of ascites cytology of hysteroscopy group were significantly higher than curettage of uterine cavity group (P < 0.05). There was no significant difference in the overall survival rate and progression free survival rate in 3 years with followup between the two groups (P > 0.05). Conclusion Curettage of uterine cavity and hysteroscopy detection before operation on patients with endometrial carcinoma posses the same diagnosis value; And hysteroscopy detection maybe peritoneal metastasis risk, but have no effect on long-term survival and larger randomized controlled trials should be necessary.